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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 38  |  Issue : 4  |  Page : 351-356

Motivations of drinking or abstaining from alcohol: A cross-sectional study among 2nd-year undergraduate students


Department of Psychiatry, Bharati Vidyapeeth Medical College, Pune, Maharashtra, India

Date of Submission23-Dec-2020
Date of Decision16-Jan-2021
Date of Acceptance09-Feb-2021
Date of Web Publication06-Jun-2022

Correspondence Address:
Dr. Manjiri Chaitanya Datar
Department of Psychiatry, Bharati Vidyapeeth Medical College, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijsp.ijsp_458_20

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  Abstract 


Background: Alcohol consumption at young age can lead to various negative medical and social consequences for college students. There are various motivations for students to consume alcohol. Few studies have been done to find out the motivations of students who prefer to stay abstinent from alcohol. Understanding the motivations of drinking and abstinence would help designing various preventive therapeutic programs for alcohol abstinence. Objectives: The objectives of the study were as follows: (1) to find the most prominent motivations for alcohol consumption and abstinence in students, (2) to compare the motivations for alcohol consumption and abstinence according to gender, and (3) to compare the motivations of students who did not ever consume alcohol with students who are abstinent for 6 months. Methodology: This was a cross-sectional study. Second-year undergraduate students of medical, engineering, and fine arts colleges who consented for the study were asked to fill pro forma about the pattern of alcohol consumption revealing the details of only age and gender. Depending on response about the last consumption of alcohol, the students were asked to fill either four-factor motivational model questionnaire for those who had consumed alcohol in the past 6 months or motivation for abstaining from alcohol questionnaire for students who had never consumed alcohol or were completely abstinent for the past 6 months. Descriptive and inferential statistical analysis using two independent sample tests was used. Results: Out of total sample of 224 students from the 3 colleges, 80 students who reported to have consumed alcohol in the past 6 months filled the four-factor motivational model questionnaire. One hundred and forty-four students who did not ever consume alcohol or were abstinent from the past 6 months filled the motivation for abstaining from alcohol questionnaire. Social and enhancement motives were most common in students consuming alcohol. Male students had more enhancement motivation than females. Among motivations to stay abstinent, fear of negative consequences of alcohol, indifference, and family constraints were the most common motives. Male students had significant fear of negative consequences and family constraints than female students. Fear of negative consequences, dispositional risk, and family constraints were significant motivations in students having alcohol abstinence for 6 months than those students who had never consumed alcohol. Conclusion: Positive motivations for alcohol consumption are predominant in college students. Knowledge of adverse consequences and family constraints play an important role in deterring students from alcohol consumption.

Keywords: Abstinence, alcohol, college, motivation


How to cite this article:
Datar MC, Shetty JV, Mali BK. Motivations of drinking or abstaining from alcohol: A cross-sectional study among 2nd-year undergraduate students. Indian J Soc Psychiatry 2022;38:351-6

How to cite this URL:
Datar MC, Shetty JV, Mali BK. Motivations of drinking or abstaining from alcohol: A cross-sectional study among 2nd-year undergraduate students. Indian J Soc Psychiatry [serial online] 2022 [cited 2022 Dec 9];38:351-6. Available from: https://www.indjsp.org/text.asp?2022/38/4/351/346573




  Introduction Top


Substance abuse is an ongoing public health concern. Worldwide, an estimated 167–315 million people between the ages of 15 and 64 use illicit substances.[1] Teenage college students are at a high risk of developing substance use, especially alcohol. Hazardous and harmful drinking patterns are on a high rise in adolescents and young adults.[2]

Drinking at young ages can have hazardous consequences such as automobile accidents, drug abuse, indiscriminate sexual activities, absenteeism at class, and decreased academic performance among some of them.[3] Research suggests that a significant proportion of students who were abstinent prior to and upon entering college do initiate drinking, and often progress to becoming heavy episodic drinkers.[4] Hence, it is important to develop preventive strategies for alcohol consumption in colleges. Successful efforts to cut down the negative consequences of alcohol in college students must be based not only on the knowledge of pattern and prevalence of alcohol but also antecedents of drinking behavior.[5]

There are various motivating factors which can lead to the initiation and continuation of alcohol use among college students. These include peer pressure, influences of media, its use by role models, and stress-related factors, which are some of the multiple etiologies driving a college student to consume alcohol.[6]

The motivation model of alcoholism states that drinking behavior has unique antecedents and consequences. For example, individuals who rely on consumption of alcohol to cope with their negative emotions probably lack adaptive ways of coping to them. In contrast, individuals who are drinking for social reasons may consider it for conformity to norms or for seeking pleasure.[7] Cox and Klinger proposed that drinking motives can be characterized into two meaningful dimensions reflecting the valence (positive or negative) and the source (internal or external). Thus, there can be four motives of drinking behavior: (1) internally generated positive reinforcement (enhancement), (2) internally generated negative reinforcement (coping), (3) externally generated positive reinforcement (social), and (4) externally generated negative reinforcement (conformity).[8] The model was developed and validated by Lynne Cooper.

Drinking motives can differ according to age, gender, personality, and various contextual factors.[9] Thus, drinking behavior is motivated by different needs and constitutes a phenomenologically different behavior.[10] Understanding the motives of drinking provides insights into the circumstances in which an individual is likely to drink, what are the consequences, and where therapeutic intervention is warranted. Thus, a number of treatment programs rely on the motivational models of drinking behavior.[11]

Less research has been done on the construct of motives not to drink in younger adolescents prior to the initiation of drinking or when drinking patterns are being established. When there are strong motivations such as conformity and other peer-related factors in college students, it is worthwhile to study the motivations of students who choose to be abstinent.[12] Given that drinking motives have been found to be more proximal and potent predictors of drinking behavior, research on absenteeism motives may be an important complement to investigations of negative expectancies in the study of drinking-related inhibitory forces.[13] Recent studies have found that “religious” or “moral” constraints, “indifference,” and “personal conviction/values” were the most common reasons for choosing not to drink.[14]

Understanding the motivations of college students for consuming alcohol can help in targeting these factors in education and empowerment programs for them. Furthermore, there is a paucity of research on knowing the motivations of those students who stay away and are completely abstinent from alcohol despite surrounding influences. The reasons for abstinence will help in chalking out preventive strategies for alcoholism in college students.


  Methodology Top


The study was planned as a cross-sectional observational study. The aim of the study was to study the motivations of alcohol consumption and abstinence in undergraduate 2nd-year students of three colleges: – medical college, engineering college, and fine arts college located in the same campus of our university. Different streams such as health sciences, technical, and arts streams were chosen to get a varied sample. Second-year students were chosen as to have students from the same age group (late teens or early 20s). Furthermore, 2nd-year students are vulnerable to risk factors like peer influence and have settled in the college environment for about 1 year or more.

The objectives of the study were as follows: (1) to find the most prominent motivations for alcohol consumption and abstinence, (2) to compare the differences in motivational factors between males and females, and (3) to compare the motivations of students who did not ever consume alcohol and students who had consumed alcohol but are completely abstinent for the past 6 months.

Inclusion criteria were all students present for their academic session giving consent. There were no exclusion criteria.

Ethics

The study protocol was presented to the institutional ethics committee and was approved before the commencement of the study.

Permission from the head of the three institutes (medical, engineering, and fine arts colleges) was taken for the study. A faculty as directed by the head of the institutes was contacted who after their academic session introduced the researchers (first and third authors) to students. The students were explained about the study and assured confidentiality. Eighty-seven out of 96 students present for the academic session in medical college, 100 out of 112 present in engineering college, and 37 out of 45 students present in fine arts college were willing to participate in the study. A subject declaration form with written informed consent was taken for participation in the study. Students were then asked to fill a pro forma questionnaire. The language of the questionnaire was English, and all students in the three colleges confirmed that they could comprehend and respond in English. The students were asked to reveal only their age and gender in the pro forma to prevent disclosure of identity and ensure that they fill genuine information. No personal interview was done. Pro formas were checked for completeness and accuracy of questionnaires filled before collecting from students.

The first question in the pro forma asked about the presence and pattern of alcohol consumption that is (a) whether they have never used alcohol, or (b) have preferred to stay completely abstinent for the past 6 months, or (c) have consumed alcohol in the past 6 months. Those students who opted answer as “c” that is who had consumed alcohol in the past 6 months were asked to fill four-factor motivational model questionnaire. The students who opted for responses “a” or “b” were asked to fill a questionnaire based on “Motives for Abstaining from Alcohol Questionnaire (MAAQ).”

The students were also asked the age of first drink if they had consumed alcohol.

Depending on their responses on Question 1, students filled either of these scales:

  1. Four-factor motivational model for alcohol questionnaire:[7],[8] It is a validated twenty-item questionnaire to assess four factors of motivation to consume alcohol. It measures two positive motivations – enhancement and social motivations – and two negative motivations – coping and conformity as motivations to consume alcohol. The responses are recorded on Likert scale of 1 (never) to 5 (almost always) depending on how important is that motivation to consume alcohol
  2. MAAQ:[14] It is a validated questionnaire for assessing motivations for alcohol abstinence. The factors for abstinence such as fear of negative consequences, dispositional risk, family constraints, religious constraints, and indifference toward drinking are assessed. Responses are recorded on Likert scale of 0 (not important) to 4 (extremely important) as how important is the motivation to stay abstinent from alcohol.


Statistical analysis

Descriptive statistics were used to describe the data. For qualitative variables, frequency and percentage were used. To compare quantitative groups, two independent samples test was used. P < 0.05 was considered statistically significant.


  Results Top


The total sample size was 224 (87 – medical, 100 – engineering, and 37 – fine arts college). All pro formas were complete and accurately filled and were included in the analysis. In response to first question in the pro forma, 124 students reported that they had never consumed alcohol, 20 students reported that they had consumed alcohol but are completely abstinent for 6 months, while 80 students reported to have consumed alcohol in the past 6 months. [Table 1] highlights the responses of students: college and gender wise about the last consumption of alcohol.
Table 1: College and gender-wise responses-Last consumption of alcohol

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Out of 100 students who had consumed alcohol (80 – current and 20 – currently abstinent for 6 months), 69% (42% of males and 27% of females) had their first drink after the age of 17. Twenty-three percent (17% of males and 6% of females) had first drink between the ages of 14 and 17 and 8% (6% of males and 2% of females) had their first drink before 14 years of age.

Out of total sample size of 224, a total of 80 students (33 – medical college, 38 – engineering college, and 9 – fine arts college) who reported to have consumed alcohol in the past 6 months filled “four-factor motivational model questionnaire.” Gender wise, 52 males and 28 females reported to have consumed alcohol in the past 6 months.

One hundred and forty-four students (54 – medical college, 62 – engineering college, and 28 – fine arts college) who did not anytime consume alcohol or were completely abstinent for 6 months filled the “MAAQ.” Gender wise, 84 males and 60 females were currently abstinent from alcohol.

The four-factor motivational model states four motives to consume alcohol – social, conformity, enhancement, and coping. The percentage mean was calculated to find the most important motivation for consumption of alcohol in students. The percentage mean of social motive was found to be the highest with a score of 54.6 (standard deviation [SD]: 20.03) followed by enhancement with a score of 52.3 (SD: 21.75). Coping and conformity had percentage mean scores of 38.75 (SD: 19.25) and 35.5 (SD: 18.05), respectively. The gender-wise correlation on four-factor motivational model questionnaire is depicted in [Table 2]. Enhancement motive was significantly found in male students as compared to female students (P = 0.053).
Table 2: Gender-wise correlation - Four-factor motivational model questionnaire

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The motives to abstain from alcohol questionnaire assess five motives – fear of negative consequences, dispositional risk, family constraints, religious constraints, and indifference. The questionnaire was filled by 144 students (124 – completely abstinent and 20 – abstinent for 6 months). The percentage mean was calculated to find the most important motivation for students to stay abstinent from alcohol. The percentage mean score of indifference as a motive to stay abstinent from alcohol was highest with the score of 66.84 (SD: 31.3) followed by family constraints with a score of 60.11 (SD: 31.12) and fear of negative consequences with a score of 60.04 (SD: 23.85). Religious constraints and dispositional risk had percentage mean scores of 37.67 (SD: 39.11) and 20.31 (SD: 17.68), respectively. [Table 3] depicts the gender-wise correlation of motivations for abstaining from alcohol scale. Fear of negative consequences (P = 0.008) and family constraints (P = 0.008) were more significant for male students as compared to female students.
Table 3: Gender-wise correlation - Motives to abstain from alcohol

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[Table 4] denotes the comparison of students who had never consumed alcohol with those who chose to be completely abstinent for 6 months. Fear of negative consequences (P = 0.033), dispositional risk (P = 0.035), and family constraints (P = 0.012) were more significant for students who have maintained complete abstinence for 6 months than students who had never consumed alcohol.
Table 4: Correlations of motives to abstain between students never consumed alcohol with students abstinent for 6 months

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  Discussion Top


The responses of college students about alcohol consumption report that 80 students out of a sample size of 224 (35.71%) currently consume alcohol. Twenty students are currently abstinent but were consuming till 6 months back (8.89%). This indicates that 44.6% of students have consumed alcohol in the sample studied. This reconfirms the general assumption that alcohol consumption is prevalent in college-going adolescents.[15],[16] The mean age of these students who recently or in the past have consumed alcohol is 20 years. The law in India on minimal age of alcohol consumption is 25, but the legal limit varies from state to state.[17] In spite of state restrictions for alcohol consumption in young adult population, it is observed to be prevalent as per observations from our study.

Maximum students (69%) have reported to have taken their first drink after the age of 17. However, 23% admitted to have taken their first drink between the ages of 14 and 17. Eight percent of students reported to have consumed alcohol below 14 years of age which is a matter of concern as studies indicate that early age of onset of alcohol consumption predicts future problem drinking in adulthood.[18],[19],[20]

The social and enhancement motives for consumption of alcohol were highest in the whole sample of students. This indicates that there are a lot of positive motivations for alcohol consumption. This corroborates to previous review which states that most adolescents report drinking for social motives, some for enhancement motives, and only a few reported coping motives.[9] Alcohol is popular in social occasions such as parties, get-togethers, and celebrations. This is the external positive motivation. A study reports that social motives exerted a strong influence on drinking status, however, predictability of heavy drinking is low.[7] However, a study indicates that social motive of drinking in adolescence is predictor of alcohol misuse.[21] Internal positive motivation is also high for alcohol consumption. Students reported to consume alcohol for enhancement that is they reported to gain “high” “excitement” and pleasure on alcohol consumption. This motive predicts heavy drinking in situations where it is encouraged.[7],[22]

Male and female students had almost similar motivational categories except that enhancement motive was statistically significant in male as compared to female students. In various studies, male adolescents had higher social and enhancement motives than girls, which indicate sensation-seeking behaviors, prominent in adolescent boys.[23] Our study did not show any gender difference in coping motives. A study reported that young adolescent girls drink alcohol as a coping strategy whereas older adolescent boys use coping motive for consumption of alcohol,[7] however, other studies did not find any gender difference in coping motivation.[24],[25]

Conformity motivation was low in the sample, indicating that peer pressure did not play a significant role in alcohol consumption. Lyne Cooper et al.[7] corroborated that conformity may be a motive for adolescents who do not have other internalized motivations for drinking.

Among those students who filled MAAQ, indifference was the highest motivating factor followed by fear of negative consequences and family constraints. The findings corroborate to study finding that self-defining personal values and lack of interest are the important motivating factors for abstinence.[12] Students prefer to stay away from alcohol and as they are aware of its negative consequences. This may be because there has been increasing awareness about the negative consequences of alcohol and also observing the peers who have loss of control and inability to abstain alcohol which was evident on their responses in motives to abstain from alcohol questionnaire.[13] Students also reported family constraints in which they reported that they were brought up to abstain from alcohol and family disapproves consumption of alcohol in general. The fear of negative consequences and family constraints were more evident in male students than female students. This may be due to reason that males may frequently be observing the peers having negative consequences of alcohol. Furthermore, family members may be more vigilant about substance consumption in boys than girls. The findings corroborate with study findings by Barnes et al. that parental monitoring has an important role to influence drinking by boys than girls.[26]

In comparison of the students who are completely abstinent or have never consumed alcohol with students who have consumed but have preferred to stay completely abstinent for the past 6 months, it was observed that the latter had significant fear of negative consequences, dispositional risk, and family constraints as a motivation to stay abstinent from alcohol. It is evident that negative personal experience could be a factor for students to make a voluntary decision to stay completely abstinent from alcohol. In a study, the factors which compelled to take alcohol again after having unpleasant effects on first drink were stress, peer pressure, and experimentation again.[5] In our study, the 20 students (8.89%) who opted to stay completely abstinent after trying alcohol in the past may have realized the negative consequences after experimentation with alcohol. Family constraints also play an important role in deterring the students from further consumption. Parental monitoring reduces the upward trajectory of alcohol misuse by adolescents as concluded by a study.[26] Family upbringing and values play a significant role in dissuading adolescents from alcohol consumption as reported by studies.[27],[28] The students also have realized certain dispositional risks which may be specific to them to voluntarily opt for abstinence from alcohol.

Limitations

No personal interview was done. Hence, the genuineness of the responses filled by the students could not be verified. The frequency and quantity of drinking were not evaluated. The samples were collected from the same age cohort from three colleges only which may not be representative of other student populations of the same age.


  Conclusion Top


Alcohol consumption is prevalent in college students pursuing different courses. Social and enhancement motivations are reported by majority of students. Fear of negative consequences, indifference, and family constraints are the important motivations for students to stay abstinent from alcohol. Fear of negative consequences, dispositional risk, and family constraints were more evident in students who have experimented with alcohol and have chosen to be completely abstinent.

Recommendations

Peer educational awareness programs in which discussions with students who have experimented with alcohol and have chosen to be abstinent can be a useful strategy for motivating students for abstinence. Such informal interactions under supervision can be more appealing to adolescents and young adult students.[29] Parents/family members training into effective communication skills with students may also be helpful for deterring them from alcohol consumption.[26]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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